NURSING IN THE CASE OF ALZHEIMER’S DISEASE: NUTRITIONAL PROBLEMS
Everyone needs to eat a well-balanced and nutritious diet. This is particularly important as a person gets older because the body is not quite so good at utilizing the essential foodstuffs as it was earlier in life. Many relatives become worried because the person they are looking after becomes less interested in food and may not eat at all on occasions. Another problem concerns the time that meals take to prepare. It often seems easier to use convenience foods if all the other problems caused by dementia make major inroads into the time available for the daily routine.
In most parts of the country, meals-on-wheels are available at least once or twice a week and although there is no choice of menu, or if so it is very restricted, the food is usually nutritious and the meal well-balanced. This is important for both the carer and the sufferer. There are also luncheon clubs but these are often difficult to get to, particularly if you feel you can’t take the dementia sufferer there. In many communities, even small villages, local pubs will often be prepared to provide meals that can be taken away. In some communities they will even deliver them regularly to an elderly confused person living on his or her own. This tends to be more expensive than meals-on-wheels, but is nevertheless a good investment.
Neighbours can be a great help in circumstances like this, for if a meal is being prepared for four people it is not really a very much greater task to increase the ingredients to feed six. This may be considerably less expensive than buying in food from a pub, local restaurant, or take-away service. Keep convenience foods, whether dried, tinned, or frozen as a back-up to rather than as a mainstay of your diet.
If you are worried about the diet that you and your confused relative may be eating seek advice from the health visitor attached to your local general practice. Prevention of illness, including that resulting from a poor diet, is one of their major functions.
Try to make mealtimes part of the regular daily routine. Don’t experiment too much with new dishes but rely upon the familiar. Don’t worry if the sufferer appears not to be eating, unless you think he or she is losing weight. “We can manage with much less food than we often realize. In the later stages of the disease, failure to eat may be caused by an inability to remember how to eat. It is at this point in the illness that it is necessary to spoonfeed the sufferer. Always make sure that solid food is cut into small pieces as it may not necessarily be chewed properly. If food intake really begins to decline and there is no obvious reason for this, such as a sore mouth or difficulty with swallowing (which should be referred to the doctor), a diet can be boosted with Complan or similar dietary supplements. The problem with some of these, if given in large quantities, is that they can cause diarrhoea. Whenever possible they should be used as a dietary supplement rather than as an alternative to normal food. If a full meal is never eaten, substitute instead small regular meals more frequently.
It is very important to remember that if a person stops eating, it may be because he or she has a painful mouth. Ill-fitting dentures are probably the most common cause of this and more and more dentists are beginning to realize that people with dementia have particular problems. If at any time there seems to be any suggestion of discomfort within the mouth, ask your dentist for an appointment. If it is difficult to take the sufferer to the dentist, many dentists will make a home visit to assess the situation.
Nowadays, more and more old people have retained some teeth, even if they also wear dentures. They can of course suffer from the same dental problems that the rest of us are subject to, and regular dental inspections are essential. Dentures should be cleaned at least once a day, if not after every meal. Do remember that ill-fitting dentures cause sores in the mouth which may not be visible unless carefully looked for, and that these in turn may lead to a person with dementia refusing to eat.
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